Kingsley Iheasirim MD

NPI 1083697684 - Internal Medicine - 207R00000X

NPI Details
NPI 1083697684
Gender Male
Enumeration Date 11/29/2005
Last Updated 11/20/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
1015 MARSH ST
MANKATO MN, 56001-5294, US
Phone (507) 389-4700
Fax
Business Location
1025 MARSH ST
MANKATO MN, 56001-4752, US
Phone (507) 625-4031
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Minnesota
License Number 46210
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According to our database, Kingsley Iheasirim MD NPI is 1083697684, taxonomy code is 207R00000X and license number is 46210, license state is located at Minnesota. Kingsley Iheasirim MD physically located at 1015 Marsh St, Mankato MN, 56001-5294. NPI Number Kingsley Iheasirim MD has the Individual type.

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1083697684 NPI number is provided on an as is basis without warranty of any kind. 1083697684 is maintained by the National Plan & Provider Enumeration System. The contents of Kingsley Iheasirim MD are for informational purposes only.